The Power of Validation

The term “validation” means a lot of things to a lot of people. For Naomi Feil, who founded and developed the Validation method in 1982 as a method for communicating with very old people who have certain forms of dementia, it has three distinct elements:

A basic, empathetic attitude

Principles that guide our actions and words

Nonverbal techniques that we use to communicate

In simple terms, it’s a way to move beyond initial conversations so you defuse confused interactions and get to the heart of the matter.

Recently I contacted Feil and her daughter, Validation master teacher Vicki de Klerk, who’s worked with her mother for almost 30 years, to learn more.

One thing is clear: These two women, who’ve coauthored books on the method, don’t like to use the word “therapy.” “Therapy connotes healing, and Validation does not heal people in the sense that they ‘get better,'” says de Klerk. “Very old people who are maloriented and disoriented respond to Validation because practitioners accept them as they are and do not try to change them. We explore their feelings and needs without judgment. Painful feelings that have been pushed down often need to be expressed, and we listen with empathy. They feel heard and valued. They keep communicating.”

Adds Feil, “Often after Validation, the old person becomes more verbal and interacts with others, especially in a Validation group.”

While some critics don’t like the concept because they see it as a form of lying, Feil and de Klerk claim that’s a common misconception. “We don’t confront with reality and we do not play-act that we believe something that is not true,” de Klerk says. “We explore the meaning of what is said or the behavior that is expressing a need or feeling. We go to a deeper level than the facts that are expressed.”

It certainly seems to be catching hold, which isn’t a surprise given the burgeoning number of older people experiencing some form dementia. There are around 300 certified Validation teachers around the world who hold meetings each year to discuss and exchange experiences. It doesn’t appear to be a static discipline by any means. “It is through these collective discussions of professionals that we adjust, change, and further develop both the practice and theory of Validation,” says de Klerk.

For these two pioneers, the long-term goals of Validation include:

–Prevention of withdrawal inward
–Decreased anxiety or anger
–Increased social behaviors
–Decreased use of chemical and physical restraints
–Help for families trying to communicate with their relative, which perhaps enables the person to remain at home longer

For those struggling to manage a parent’s (or loved one’s) dementia using the precepts of Validation techniques, Feil and de Klerk offer three concrete tips:

Understand the person’s needs clearly

Often caregivers mistakenly project their own needs and feelings onto the loved one. “The son may want his mother to sit in the chair and stop trying to ‘go home,'” says de Klerk. “The mother’s need may be to feel like a good mother and take care of her children when they come home from school.”

Make eye contact and choose a comfortable distance

How you say something is as important as what you say. Eye contact and physical positioning count. “Get in front of that person and not on the side or behind,” says de Klerk. “Bend so that you are at eye level (not from above) and get close so the person feels your presence, but not too close — find the distance that is comfortable for the older person.”

Center yourself before you attempt Validation

One of the hardest aspects of communicating with someone in the throes of dementia is to avoid quick reactions. “Put aside your thoughts and feelings for the few minutes you want to communicate on a deep level,” says de Klerk. “Be open without judgment and simply take in what you see, hear, and feel. Then explore the meaning behind the behavior.”

Once you’re well into the practice and want to gauge its success for yourself, consider these questions:
Is there communication on some level?
Have I built trust with the person?
Do I have an empathetic relationship with person, so that he or she feels motivated to express emotions and unexpressed needs?
At the end of a session, does the person have a greater sense of self-worth? Has the person expressed what’s on his/her mind, and does he/she feel relieved? Is there less stress?